Bedeutung von Spermiogrammparametern in Nativ-Spermiogrammen und in Ejakulat-Aufbereitungen im Rahmen der In-Vitro-Fertilisation (IVF)

The objective of this study was to evaluate the influence of human sperm parameters on fertilization in the context of IVF treatment before and after preparation of the semen sample. For several parameters threshold values were determined. Below those limits no fertilization was observed. Further the relationship between fertilization and the couple´s age, previous partnerships with and without birth of a child, the FSH level and the women´s body mass index were examined. The univariate analysis of the basic semen analysis showed a significant relationship between fertilization and the sperm parameters concentration, total sperm count, motility, long-term motility, morphology, multiple morphological sperm defects, sperm-vitality, chromatin condensation and acrosin activity. The univariate analysis of the native and the prepared semen samples showed significant positive correlations between fertilization and sperm concentration, sperm number and motility. There was a significant relationship between fertilization and the women´s age in the univariate analysis. However, the cycles in the group of the younger patients showed lower fertilization rates than in the group of older patients. The reason for the low fertilization rate was a poorer sperm-quality of the male partners of the younger women. Threshold values of the single parameters were determined in the univariate analysis. A threshold was defined as the value below which no fertilization was documented: before and after preparation of the semen sample 11.4 Mio., Total sperm count native sperm analysis 3.8 Mio., Progressive motility basic sperm analysis 11 %, Progressive motility basic sperm analysis 11 %, Sperm concentration native analysis 7 Mio./ml, Sperm motility after 2 hours 22 %, Sperm vitality test 25 %, Hypo-osmotic swelling test 28 %.Parameters within the significance level p < 0.05 as revealed by univariate analysis, were analysed by a binary logistic regression model. Sperm motility after 2 hours (p = 0.043) and sperm concentration in the native analysis (p = 0.008) had a significant impact on fertilization.Semen analysis is a central component in male fertility testing. However, fertilization depends on many factors. Semen analysis on its own cannot predict the likelihood of fertilization. Although fertile men have better semen parameters on average than infertile men, there is a big overlap between the groups. Therefore it is not easy to clearly distinguish between fertile and infertile patients based on specific values. However, it does increase the probability of fertilization if values are over defined limits